Once occupying over 50 major village sites throughout the central coast, the Heiltsuk maintain a strong sense of history and continued ties to land and marine resources and other cultural sites. Heiltsuk ancestral territory stretches from the southern tip of Calvert Island to Klekane Inlet across from Butedale in Graham Reach, and from the Goose Island Banks and outer islands, inland to Kimsquit and the head of Dean Channel.

Fort McLoughlin was established by the Hudson's Bay Company on Campbell Island in Heiltsuk territory in 1833. The Heiltsuk community of Bella Bella grew up around the fort at McLoughlin Bay and controlled the trade in the area.

The Heiltsuk were greatly affected, as were other First Nations, by epidemics that started with the sea-based and northern fur trade long before the well-known smallpox epidemic of 1862. Although maintaining ancestral ties and seasonal use at ancient village sites, survivors successively amalgamated and relocated to a number of communities including Bella Bella, which became the primary Heiltsuk settlement by the late 1890s.